This document compares several pharmacokinetic models for adult and pediatric propofol administration. It includes tables showing the parameter values for different models of propofol, remifentanil, sufentanil, alfentanil and fentanyl. The models are evaluated based on their median prediction error, median absolute prediction error, wobble and divergence in predicting drug concentrations over different infusion durations. Graphs show predicted propofol concentrations and context-sensitive half-times for a child using different pharmacokinetic models.

1. Table 1 : Adult propofol models
Marsh42 Schnider45
General 70 kg General model 70 kg,
model (LMB calculated using weight, male height
height, gender) 170 cm
MODÈLES V1
V2
0.228 L/kg
0.463 L/kg
15.9 L
32.4 L
4.27 L
18.9–0.391 x (age–53) L
4.27 L
24.0 L
PHARMACOCINÉTIQUES
V3 2.893 L/kg 202.0 L 238 L 238 L
K10(min-1) 0.119 0.119 0.443 + 0.0107 x 5 (weight– 0.384
77) – 0.0159 x (LMB–59) +
0.0062 x (height–177)
K12(min-1) 0.112 0.112 0.302 – 0.0056 x (age–53) 0.375
G. Janvier K13(min-1) 0.042 0.042 0.196 0.196
K21(min-1) 0.055 0.055 [1.29-0.024 x (age–53)] / 0.067
[18.9 – 0.391 x (age–53)]
Service d’Anesthésie Réanimation II, CHU de Bordeaux, K31 (min-1) 0.0033 0.0033 0.0035 0.004
Groupe Hospitalier Sud, 33604 Pessac cedex Keo(min-1) 0.26123 0.26 0.456 0.456
15/02/2008 TTPE (min) 4.5124 4.5 1.69 1.69
Table 2: Paediatric propofol models
Table 3: Other models
Paedfusor49† Kataria48
Model 20 kg patient Model 20 kg patient Remifentanil (Minto)53
V1 0.458 L/kg 9.2 L 0.52 L/kg 10.4 L Vc (L) 5.1 - 0.0201 x (age-40) + 0.072 x (LMB - 55)
V2 1.34 L/kg 26.8 L 1.0 L/kg 20 L V2 (L) 9.82 - 0.0811 x (age-40) + 0.108 x (LMB - 55)
V3 8.20 L/kg 163.9 L 8.2 L/kg 164 L V3 (L) 5.42
K10(min-1) 70 x Weight-0.3/ 0.062 0.066 0.066
K10 (min-1) [(2.6 - 0.0162 x (age-40) + 0.0191 x (LMB -
458.4 55)] / Vc
K12(min-1) 0.12 0.12 0.113 0.113 K12 (min-1) [(2.05 - 0.0301 x (age-40)] / Vc
K13(min-1) 0.034 0.034 0.051 0.051 K13 (min-1) [0.076 - 0.00113 x (age-40)] / Vc
K21(min-1) 0.041 0.041 0.059 0.059 K21 (min-1) K12 x Vc / V2
K31 (min-1) K13 x Vc / V3
K31(min-1) 0.0019 0.0019 0.0032 0.0032
Keo (min-1) 0.595 - 0.007 x (age-40)
†. This model applies to children < 16 years old
Table 3: Other models Table 3:Other models
Alfentanil Fentanyl
(Maitre)63 (Shafer)28
Sufentanil Sufentanil
(Bovill)56 (Gepts)55 Vc (L) Male: 0.111 L/kg 6.09
Female: 1.15 x 0.111 L/kg
Vc (L) 0.164 L/kg 14.3
V2 (L) 12.0 28.1
V2 (L) 0.359 L/kg 63.4 V3 (L) 10.5 228
V3 (L) 1.263 L/kg 251.9 K10 (min-1) Age <= 40 years: 0.356 / Vc 0.083
K10 (min-1) 0.089 0.0645 Age < 40: 0.356 – [0.00269 x (age-40)] / Vc
K12 (min-1) 0.35 0.1086
K12 (min-1) 0.104 0.4713
K13 (min-1) 0.017 0.22496
K13 (min-1) 0.077 0.0229
K21 (min-1) 0.067 0.1021
K21 (min-1) 0.16 0.0245
K31 (min-1) Age <= 40 years: 0.0126 0.00601
K31 (min-1) 0.01 0.0013 Age < 40: 0.0126 –0.000113 x (age-40)
Keo (min-1) 0.12 0.112 Keo (min-1) 0.77 (125) 0.147 (125)
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2. Table 4: Predictive performance of commonly used Infusion Propofol / Propofol / Propofol /
duration afentanil sufentanil remifentanil
pharmacokinetic models (min) (µg/ml; ng/ml) (µg/ml; ng/ml) (µg/ml; ng/ml)
Drug Propofol Remifentanil Sufentanil Afentanil 15 Coptimal 3.25 / 99.3 3.57 / 0.17 2.57 / 4.70
Cawakening 1.69 / 65.0 1.70 / 0.10 1.83 / 1.93
Model Marsh42 Paedfusor49 Minto53 Gepts55 Maitre63 Time to awakening 8.2 9.4 5.1
(min)
Investigating Coetzee98 Swinhoe Absalom49 Mertens102 Barvais103 Maitre63 60 Coptimal 3.38 / 89.7 3.34 / 0.14 2.51 / 4.78
99
author Cawakening 1.70 / 64.9 1.70 / 0.10 1.83 / 1.93
Time to awakening 12.2 11.9 6.1
MDPE (%)
(min)
(Médiane des -7.0 16.2 4.1 -15 -22.9 -7.9
Prediction Error) 300 Coptimal 3.40 / 88.9 3.37 / 0.14 2.51 / 4.78
MDAPE (%) Cawakening 1.70 / 64.9 1.70 / 0.10 1.86 / 1.88
(Médiane des Time to awakening 16.0 15.6 6.7
valeurs absolues 18.2 24.1 9.7 20 29.0 22.3 (min)
des Prediction
Error) Propofol/opioid combinations estimated by Vuyk et al to be associated with the fastest recovery
Wobble (%) from anaesthesia.
(Cohésion) 10.0 21.9 8.3 16 - - Coptimal represents combinations associated with a 50% probability of a response to surgical
stimuli; Cawakening concentrations represent the estimated concentrations at which consciousness
Divergence (%) will be regained and Times to awakening represent the estimated time from termination of the
(Divergence) 6.5 -7.6 - 5 - - infusion to return of consciousness in 50% of patients. (From Vuyk157)
Predicted blood propofol concentrations after a 120 min infusion Context-sensitive half-times after propofol infusions of various
of propofol 4 mg kg1 h1 into a 20 kg child aged 5 yr. lengths into a 20 kg child aged 5 yr.
Four pharmacokinetic models are compared. Plots represent, from top to bottom: Plots represent, from bottom to top: Marsh and Gepts Diprifusor model, mostly
Marsh and Gepts Diprifusor model, mostly based on adult data; Rigby-Jones model, based on adult data ; Rigby-Jones model, paediatric, postcardiac surgery ; Paedfusor
postcardiac surgery; Paedfusor and Schuttler. Thick solid line shows pooled analysis and Schuttler. Thick solid line shows pooled analysis including data from healthy
including data from healthy children. children.
Sneyd J.R., BJA 2004; 93: 725-36 Sneyd J.R., BJA 2004; 93: 725-36
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